Introduction The prognosis of chronic inflammatory diseases has been transformed by the use of bi... more Introduction The prognosis of chronic inflammatory diseases has been transformed by the use of biologic drugs. However, there is evidence of an increased risk of infection in patients undergoing biotherapy. The objective of our study was to investigate the frequency and the severity of infections in patients on biotherapy. Methods We conducted a retrospective descriptive study including all patients followed in the internal medicine department of the ISF hospital and treated with biotherapy over a period of 14 years [2009–2022]. Results We identified 50 patients treated with biologic therapy among 76 patients. The patient’s mean age was 48 years± 12.5 [23–76] and male to female ratio (M: F) was 1 :6. The mean age at initiation of biotherapy was 41.3 ± 11.6 [17–68] years. The molecules used were TNFα inhibitors in 82% of cases, rituximab in 14% of cases and tocilizumab in 4%. Infectious complications were identified in 20 patients. Infections occurred after a mean duration of 12 mont...
Introduction The increasing use of biologics in chronic inflammatory diseases is accompanied by a... more Introduction The increasing use of biologics in chronic inflammatory diseases is accompanied by an increased risk of infectious complications. Our objective was to determine the predictive factors for the occurrence of infection in patients on biotherapy. Methods We conducted a single-center retrospective study in an internal medicine department over a period of 14-year [2009–2022], including the records of patients treated with a biologic agent presenting at least one infectious episode. Results During the study period, 20 patients among 50 treated with biologic agent had at least one infection episode. The patient mean age was 50.8 ± 12.1 [24–76] years and the male to female ratio was 1:2. The mean age at biotherapy first use was 43 ± 12.1 [17–68] years. Infections occurred after a mean duration of 12 months [0.5–36] after the initiation of biotherapy. Eleven patients were followed for chronic inflammatory bowel disease, three patients for ankylosing spondylitis, three patients fo...
Intestinal pseudo-obstruction (IPO) is defined as an intestinal obstruction without mechanical ob... more Intestinal pseudo-obstruction (IPO) is defined as an intestinal obstruction without mechanical obstructive lesion. It's a rare complication of systemic lupus erythematosus (SLE). We report a case of SLE inaugurated by IPO to emphasize the importance of early recognition of the diagnosis especially that SLE-related IPO responds well to corticosteroid therapy.
Background: Colic pseudolipomatosis is a rare and benign condition of which many endoscopists and... more Background: Colic pseudolipomatosis is a rare and benign condition of which many endoscopists and pathologists are unaware. Several pathogenic mechanisms have been postulated. For a better understanding and recognition of this uncommon lesion with particular attention to its etiology, we report and discuss a series of patients in whom colonic pseudolipomatosis was found during routine colonoscopy and occurring in an epidemic pattern.Methods: This was an observational cross-sectional study reporting a form of unprecedented colitis, colonic pseudolipomatosis, observed in a series of patients at our endoscopy center during a 3−month period in late 2021 (October - December). We collected demographic/clinical data, endoscopic and histological findings from all included patients. For statistical analysis, we used the simple method of ratio to provide percentagesResults: In total, eight patients were included. Their median age was 59,5 years with a male/female sex ratio of 0.6. During endo...
BACKGROUND Iron deficiency is the most common nutritional deficiency worldwide and its resulting ... more BACKGROUND Iron deficiency is the most common nutritional deficiency worldwide and its resulting anemia appears as a public health problem. Iron deficiency anemia is rather a symptom than a disease in itself, and the identification of its etiology is of paramount importance. AIM to study the clinical and etiological features of iron deficiency anemia in an Internal Medicine department. METHODS We conducted a retrospective descriptive study between 2001 and 2015 at an internal medicine department including patients presenting with iron deficiency anemia and having at least one etiological investigation. RESULTS The average age was 45.6 16,3 years. Three main mechanisms of iron deficiency anemia were noted: repeated blood loss (94.4%), digestive malabsorption of iron (17.8%) and lack of dietary iron intake (6.6%). The digestive origin dominated the etiologies of iron deficiency anemia with a leading frequency of gastritis (32.2%). An underlying cancer was discovered in six cases. T...
Multiple biliary hamartomas (MBH) are a rare cause of multiple benign hepatic lesions. The condit... more Multiple biliary hamartomas (MBH) are a rare cause of multiple benign hepatic lesions. The condition is also known as von Meyenburg complexes, multiple bile duct hamartomas and biliary microhamartomas. MBH is asymptomatic and usually found incidentally, where it is important to differentiate from other causes of multiple liver lesions, particularly metastases. In this report, a case of biliary hamartoma mimicking pneumobilia is presented.
Purpose: We report here a case of inflammatory bursitis in a patient with crohn’s disease after s... more Purpose: We report here a case of inflammatory bursitis in a patient with crohn’s disease after switching to biosimilar infliximab. Methods: The patient's clinical, biological and imaging data were reviewed as well as the literature on inflammatory bursitis in patients under infliximab therapy. Results: A 41-year-old man with crohn’s disease evolving from 3 years was referred to infliximab therapy at a dose of 5mg/kg because of an aggressive resistant perineal fistula. After 14 infusions of infliximab, the treatment was switched to infliximab biosimilar using the same dose and frequency of administration. Forty-eight hours after the second infusion, he developed an acute onset of muscle pain and stiffness on both of his shoulders. A muskuloskeletal ultrasound was performed and revealed a hypoechoic widening of both of subacromial bursae, more severe on the left side. The diagnosis of non infective sub-acromial bursitis secondary to infliximab infusion was made as the patient’s s...
Introduction The prognosis of chronic inflammatory diseases has been transformed by the use of bi... more Introduction The prognosis of chronic inflammatory diseases has been transformed by the use of biologic drugs. However, there is evidence of an increased risk of infection in patients undergoing biotherapy. The objective of our study was to investigate the frequency and the severity of infections in patients on biotherapy. Methods We conducted a retrospective descriptive study including all patients followed in the internal medicine department of the ISF hospital and treated with biotherapy over a period of 14 years [2009–2022]. Results We identified 50 patients treated with biologic therapy among 76 patients. The patient’s mean age was 48 years± 12.5 [23–76] and male to female ratio (M: F) was 1 :6. The mean age at initiation of biotherapy was 41.3 ± 11.6 [17–68] years. The molecules used were TNFα inhibitors in 82% of cases, rituximab in 14% of cases and tocilizumab in 4%. Infectious complications were identified in 20 patients. Infections occurred after a mean duration of 12 mont...
Introduction The increasing use of biologics in chronic inflammatory diseases is accompanied by a... more Introduction The increasing use of biologics in chronic inflammatory diseases is accompanied by an increased risk of infectious complications. Our objective was to determine the predictive factors for the occurrence of infection in patients on biotherapy. Methods We conducted a single-center retrospective study in an internal medicine department over a period of 14-year [2009–2022], including the records of patients treated with a biologic agent presenting at least one infectious episode. Results During the study period, 20 patients among 50 treated with biologic agent had at least one infection episode. The patient mean age was 50.8 ± 12.1 [24–76] years and the male to female ratio was 1:2. The mean age at biotherapy first use was 43 ± 12.1 [17–68] years. Infections occurred after a mean duration of 12 months [0.5–36] after the initiation of biotherapy. Eleven patients were followed for chronic inflammatory bowel disease, three patients for ankylosing spondylitis, three patients fo...
Intestinal pseudo-obstruction (IPO) is defined as an intestinal obstruction without mechanical ob... more Intestinal pseudo-obstruction (IPO) is defined as an intestinal obstruction without mechanical obstructive lesion. It's a rare complication of systemic lupus erythematosus (SLE). We report a case of SLE inaugurated by IPO to emphasize the importance of early recognition of the diagnosis especially that SLE-related IPO responds well to corticosteroid therapy.
Background: Colic pseudolipomatosis is a rare and benign condition of which many endoscopists and... more Background: Colic pseudolipomatosis is a rare and benign condition of which many endoscopists and pathologists are unaware. Several pathogenic mechanisms have been postulated. For a better understanding and recognition of this uncommon lesion with particular attention to its etiology, we report and discuss a series of patients in whom colonic pseudolipomatosis was found during routine colonoscopy and occurring in an epidemic pattern.Methods: This was an observational cross-sectional study reporting a form of unprecedented colitis, colonic pseudolipomatosis, observed in a series of patients at our endoscopy center during a 3−month period in late 2021 (October - December). We collected demographic/clinical data, endoscopic and histological findings from all included patients. For statistical analysis, we used the simple method of ratio to provide percentagesResults: In total, eight patients were included. Their median age was 59,5 years with a male/female sex ratio of 0.6. During endo...
BACKGROUND Iron deficiency is the most common nutritional deficiency worldwide and its resulting ... more BACKGROUND Iron deficiency is the most common nutritional deficiency worldwide and its resulting anemia appears as a public health problem. Iron deficiency anemia is rather a symptom than a disease in itself, and the identification of its etiology is of paramount importance. AIM to study the clinical and etiological features of iron deficiency anemia in an Internal Medicine department. METHODS We conducted a retrospective descriptive study between 2001 and 2015 at an internal medicine department including patients presenting with iron deficiency anemia and having at least one etiological investigation. RESULTS The average age was 45.6 16,3 years. Three main mechanisms of iron deficiency anemia were noted: repeated blood loss (94.4%), digestive malabsorption of iron (17.8%) and lack of dietary iron intake (6.6%). The digestive origin dominated the etiologies of iron deficiency anemia with a leading frequency of gastritis (32.2%). An underlying cancer was discovered in six cases. T...
Multiple biliary hamartomas (MBH) are a rare cause of multiple benign hepatic lesions. The condit... more Multiple biliary hamartomas (MBH) are a rare cause of multiple benign hepatic lesions. The condition is also known as von Meyenburg complexes, multiple bile duct hamartomas and biliary microhamartomas. MBH is asymptomatic and usually found incidentally, where it is important to differentiate from other causes of multiple liver lesions, particularly metastases. In this report, a case of biliary hamartoma mimicking pneumobilia is presented.
Purpose: We report here a case of inflammatory bursitis in a patient with crohn’s disease after s... more Purpose: We report here a case of inflammatory bursitis in a patient with crohn’s disease after switching to biosimilar infliximab. Methods: The patient's clinical, biological and imaging data were reviewed as well as the literature on inflammatory bursitis in patients under infliximab therapy. Results: A 41-year-old man with crohn’s disease evolving from 3 years was referred to infliximab therapy at a dose of 5mg/kg because of an aggressive resistant perineal fistula. After 14 infusions of infliximab, the treatment was switched to infliximab biosimilar using the same dose and frequency of administration. Forty-eight hours after the second infusion, he developed an acute onset of muscle pain and stiffness on both of his shoulders. A muskuloskeletal ultrasound was performed and revealed a hypoechoic widening of both of subacromial bursae, more severe on the left side. The diagnosis of non infective sub-acromial bursitis secondary to infliximab infusion was made as the patient’s s...
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